South Sudan
Our Activities in South SudanTensions within the new country broke into armed conflict in December 2013, claiming tens of thousands of lives before a fragile peace agreement took hold in the summer of 2015.
Hostility continues to simmer, hampering efforts to improve public health standards in a country that has one of the world’s highest infant-mortality rates. The food-security situation remains desperate and the number of people at risk of starvation has increased.
Potential for disease is extremely high, with large numbers of displaced people and sharply reduced access to healthcare. ACEPO currently operates in three of the country’s three states, providing healthcare, nutrition, mental health and protection services.
Key Protection Needs
Safety and security: The IDPs fear going to the bush to collect firewood and materials needed to build shelter, and due to the restricted movement, they are unable to provide livelihood opportunities for themselves. Women and girls also fear being attacked while fetching water at the riverside, especially in the evening. While on the move, IDPs reported cases of extortions, rape, and abductions by unidentified groups.
GBV: IDPs leaving the 12 stores known as waystations are sharing limited space, which has led to congestion due to limited shelter. There are no latrines on site, and women and girls need to walk to a distant location, which exposes them to the risk of GBV. Incidents of sexual violence were reported.
UASCs: 24 unaccompanied or separated children were identified and referred to relevant service providers.
Lack of Food: IDPs arrived in Malakal without resources. Due to the limited response in terms of food and other livelihood activities by religious organizations and only cereals by WFP, IDPs cannot cultivate land due to access and a lack of tools. As a result, there is a high risk of food insecurity in Malakal, with many IDPs reporting negative coping mechanisms (eating wild food, eating once every two days, etc.). Many IDPs reported being sick because of eating lollipop seeds for most meals.
Health: IDPs arrived traumatized and exhausted as they had to cross the river Sobat and walk for 5 to 12 days to arrive in Malakal. Many report difficulties accessing health services, including MHPSS, due to distance to service points and lack of funds. FGDs conducted by protection partners on the services available revealed information on cholera cases. MSF and IMC are providing health services on an emergency basis at the site.
Shelter/NFIs – Waystation: Due to strong winds, the roofs were blown away. IDPs leaving near the Malakal Stadium are living in an open space without proper shelter. Protection Cluster and partners responded with NFIs targeting 380 people with special needs (PSNs) in both sites; however, more NFIs are needed as many continued to sleep in inadequate conditions, which increased their vulnerability and GBV risks.
WASH Services – Waystation: are limited and not widely available. There is a lack of clean drinking water for the community, and people drink water directly from the river, increasing their exposure to water-borne diseases. Due to the limited number of latrines, open defecation is practiced. This is of particular concern during the time of the cholera outbreak in Malakal.
Our Response
Primary and secondary healthcare
ACEPO-Africa provides basic primary healthcare across Western Bahr el Ghazal, Jonglei and Upper Nile States in displacement camps. ACEPO also runs comprehensive health facilities that offer higher-level care, including surgery. In Juba, the health facility in the camp includes a 24-hour emergency department as well as intensive-care units for adults and children. In collaboration with the World Health Organization and South Sudan’s national Ministry of Health, ACEPO-Africa plans to deploy a team of specialists to set up an intensive-care unit (ICU) and provide care to critical patients at the hospital. The team will also help assess and eventually establish a Level 2 ICU unit at the facility that would be equipped with complex life-support systems and other modern equipment, to enable a higher level of care for severe and critical patients. If completed as envisioned, the facility would be the first of its kind in the country that would be fully accessible to the public. It would also allow for eventual teaching and researching components.
Maternal and Child Health
With one in every 50 live births resulting in the death of the mother, South Sudan has one of the highest maternal-mortality rates in the world. Due in part to the high fertility rate, each mother has a one-in-seven chance of dying in childbirth during her lifetime. Babies are at even greater risk: 25% die from common, often preventable, childhood illnesses before they reach their fifth birthday. The high-impact services that ACEPO implements in primary health clinics in South Sudan focus on improving the health of women and their children. Several of its primary and secondary health facilities also provide emergency obstetric care, ensuring care for women and children.
Nutrition
In some of the areas where ACEPO-Africa works in South Sudan, more than one-third of children under five are affected by chronic or acute malnutrition, which can cause moderate or severe stunting. High prices for food staples, disruptions to livestock and crop production, currency devaluation, limited humanitarian access and conflict-related displacement are responsible for the high levels of food insecurity throughout the country. Through 13 program sites, ACEPO has implemented successful programs using the community-based management of acute malnutrition model, along with a maternal, infant and young-child feeding approach, as curative and preventive measures. As of February 2022, ACEPO-Africa reached more than 6,000 malnourished children and almost 8,100 pregnant and breastfeeding women with nutrition services. We have also supported more than 400 mother support groups who implement and advocate for nutrition and dietary behavior change at the community level.
Capacity Strengthening
For every service we provide, ACEPO-Africa works closely with local and government counterparts and donors. At our primary healthcare clinics, the majority of staff members are South Sudanese who receive training, support and guidance from experienced Sudanese or expatriate staff. We previously supported three midwifery schools, where men and women completed a rigorous two-year course of study to become midwives. From 2021 to 2022, we enabled 200 nurses and midwives to graduate; many of those midwives now work for our organization.
Gender-based Violence (GBV)
Violence against women and girls is an endemic problem in South Sudan, exacerbated by ongoing conflict and chronic displacement. As such, ACEPO puts gender-based violence (GBV) prevention and response at the core of its lifesaving interventions. Our programs are tailored to support and empower women and girls who are most affected by abuse and violence, and who face particular risks during and after armed conflict and natural disaster. Our services include quality case management using a survivor-centered approach, along with counseling and psychosocial support that includes referral to health centers for clinical management of rape and legal justice services based on the needs and wishes of survivors. In addition, we run women- and girl-friendly spaces and offer livelihood activities in camps in Wau and Malakal, as well as within communities in Nyal, Aburoc, Malakal Town, Wau and Akobo counties.